Scene One. November 2019. In an open letter to Congress, the President of the Direct Primary Care Coalition explains that, under current law, payment of subscription fees to a DPC makes an individual ineligible to contribute to an HSA. Calls for passage of a legislative fix.
Scene Two. March 2020. Discussing exclusion of the DPC/HSA fix from the CARES Act of 2020 in an March 2020 webinar, the Executive Director of the Direct Primary Care Coalition advises attending DPC practitioners that they have no responsibility for advising their patients of any tax consequences that might befall them if they subscribe to DPC. Calls for DPC docs to advocate for a fix, presumably by giving their patients’ legislators the very information they do not find themselves obliged to give to their patients.
Scene Three. Flashback, months before November 2019 and, flashforward, into the present (6/2/2020). Website of a Founding Member/Board Member of the DPC Alliance:
“Are DirectAccess’s monthly fees eligible for HSA or FSA reimbursement?”
Yes, our fees are generally reimbursable. This is one smart method of paying for your health care needs with pre-tax dollars.”https://www.directaccess.md/faq
In fact, that precise misrepresentation appears in an FAQ section of a website template designed for DPC clinics across multiple states. Moreover, a number of individual DPC clinics actively recommend their patients to get an HSA, like this this one for example by yet another Founding Member of DPC Alliance:
As a patient of Forest DPC, will I still need health insurance?
Yes. We recommend that our clients continue to carry a medical plan and a health savings account, thereby ensuring financial help should hospitalization or referral to a specialist be necessary.https://forestdirectprimarycare.com/faq/
And, while there are other DPC clinic websites that are significantly less misleading, I’ve looked at nearly a hundred of them and seen not one that directly warns patients that purchasing a DPC subscription puts their HSA at risk.
Scene Four. June 2020. DPC Alliance continues the push for the DPC/HSA legislative fix to conform tax law so that in the future it will conform to these past and present misrepresentations of the law.